| Westside Medical Group | |
|
714 Chase Parkway Suite 6 Waterbury CT 06708-3939 | |
| (203) 755-4577 | |
| (203) 756-3628 |
| Full Name | Westside Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 714 Chase Parkway, Waterbury, Connecticut |
| Authorized Official Name and Position | Mark Lawrence Kraus (PRESIDENT) |
| Authorized Official Contact | 2037554577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Westside Medical Group 714 Chase Parkway Suite 6 Waterbury CT 06708-3939 Ph: (203) 755-4577 | Westside Medical Group 714 Chase Parkway Suite 6 Waterbury CT 06708-3939 Ph: (203) 755-4577 |
| NPI Number | 1083724967 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 01/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083724967 | NPI | - | NPPES |
| 004085800 | Medicaid | CT | |
| 50WESTSIDECT01 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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